EP2855685B1 - Vecteurs adénoviraux pour la transduction du tissu vasculaire - Google Patents
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- EP2855685B1 EP2855685B1 EP13725613.7A EP13725613A EP2855685B1 EP 2855685 B1 EP2855685 B1 EP 2855685B1 EP 13725613 A EP13725613 A EP 13725613A EP 2855685 B1 EP2855685 B1 EP 2855685B1
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Definitions
- the invention relates to the field of gene transfer, and in particular to the use of adenoviral vectors for gene delivery to vascular tissue.
- Ads Adenoviruses
- Ad2 Ad5
- the first generation E1/E3 deleted vectors can accommodate ⁇ 8 kb of inserts whereas helper dependent Ads can accommodate up to 37 kb of foreign genetic material.
- Ads were first isolated and cultured in 1953 from adenoid cells and to date 55 human adenovirus serotypes have been identified and grouped in six species (A-F). Most of these serotypes cause mild infection of the upper respiratory tract, gastroenteritis or conjunctivitis. Moreover, wildtype (WT) adenovirus has been used as a vaccine for US military recruits and showed to cause very few side effects. This contributed to the idea that Ads are safe viruses to use for human gene therapy, although high doses of adenovirus may cause an overwhelming immune response. 17, 18, 19 However, local ex vivo gene transfer reduces these problems.
- Ads as vectors clinically
- the high rates of pre-existing neutralising antibodies in most humans leading to rapid neutralization upon administration in the circulation are rapidly sequestered by the liver, thus failing to reach their target cells or tissues to a sufficient extent for their intended purpose.
- increasing the vector dosage as an attempt to overcome these problems has proven to be inadequate and sometimes toxic, or even lethal.
- Ad5 Adenovirus serotype 5
- Ad5 Adenovirus serotype 5
- Ad5 Adenovirus serotype 5
- uptake of adenovirus into the vessel wall and the resulting level of gene transfer mediated through Ad5 is relatively poor and necessitates high input titers of virus.
- Ad pseudotypes chimeric human Ads
- non-human Ads or Ad vectors with low seroprevalence in order to avoid the immune response and detarget the vectors away from the liver and retarget them to cells and tissues of interest.
- Ad pseudotypes chimeric human Ads
- non-human Ads or Ad vectors with low seroprevalence in order to avoid the immune response and detarget the vectors away from the liver and retarget them to cells and tissues of interest.
- Preuss et al. (The Open Gene Therapy Journal, 2008, 1, 7-11 ) describe tropism-modified adenoviral vectors for transducing endothelial cells. Nettelbeck et al. (Mol.
- Therap., 2001, 3, 882 disclose bi-specific antibodies used as molecular bridge linking the adenovirus capsid to the endothelial cell surface protein endoglin for vascular targeting of adenoviruses.
- US 2005/0084480 describes use of Ad35 serotype for gene delivery.
- the human adenovirus family is extensive with many rare and understudied adenoviruses (currently 55 known serotypes). At present, little is known about their tropism or potential for use as novel vectors, seriously limiting their practical application.
- Ad49 adenovirus serotype 49
- Ad49 a rare species D adenovirus
- the invention provides an adenoviral gene delivery vehicle for use in a method of therapeutic or prophylactic gene delivery to a vascular cell or tissue, wherein the adenoviral gene delivery vehicle comprises an Ad49 hexon protein, an Ad49 penton protein and an Ad49 fiber protein.
- Such a method may involve direct administration of the adenoviral gene delivery vehicle to a subject.
- the contacting step may also be performed in vitro or ex vivo.
- the method may be applied to a vascular cell or tissue intended for introduction to a subject, e.g. a vascular tissue graft.
- the method may comprise the steps of providing a vascular cell or tissue, contacting the cell or tissue with an adenoviral gene delivery vehicle to provide genetically modified cell or tissue, and introducing the genetically modified cell or tissue to a subject.
- the invention also provides an in vitro or ex vivo method of gene delivery to a vascular cell or tissue comprising contacting said vascular cell or tissue in vitro or ex vivo with an adenoviral gene delivery vehicle which comprises an Ad49 hexon protein, an Ad49 penton protein and an Ad49 fiber protein.
- vascular is used in this specification to refer to blood vessels, primarily veins and arteries, but encompassing other vessel types such as arterioles, venules and capillaries where the context permits.
- the vascular cell or tissue to be transduced may comprise one or more vascular endothelial cells (ECs) and/or one or more vascular smooth muscle cells (SMCs). It may comprise a length of blood vessel, e.g. a length of vein or artery.
- ECs vascular endothelial cells
- SMCs vascular smooth muscle cells
- the cell or tissue may have been obtained directly from the subject (or, less frequently, from a third party donor) prior to being contacted with the adenoviral gene delivery vehicle, for example, as part of the same surgical procedure.
- Such methods are generally referred to as ex vivo gene delivery methods.
- the length of blood vessel is typically an explant, derived, for example, from saphenous vein, internal mammary artery (e.g. left internal mammary artery), gastroepiploic artery (e.g. right gastroepiploic artery), and inferior epigastric artery.
- the explant may be contacted with the adenoviral gene delivery vehicle within 1 hour of extraction from the donor, within 45 minutes, within 30 minutes, within 15 minutes, within 10 minutes, within 5 minutes or within 1 minute of extraction from the donor.
- the cell or tissue may have been cultured in vitro for a period of time prior to contacting with the adenoviral gene delivery vehicle, e.g. for a period of one or more hours, days or weeks.
- the cell or tissue may have been generated in vitro, e.g. from one or more stem cells, by growth and differentiation under appropriate culture conditions.
- the stem cells may be syngeneic with the subject to whom the cell or tissue is to be administered. For example, they may have been obtained directly or indirectly from the subject themselves. Alternatively they may have been obtained directly or indirectly from a third party donor.
- the vascular cell or tissue may be contacted with the gene delivery vehicle for as long as necessary to achieve adequate transduction. Often, however, a period of one hour or less may suffice, e.g. 45 minutes or less, 30 minutes or less, 15 minutes or less, or 10 minutes or less.
- the vascular cell or tissue may be contacted with the gene delivery vehicle for a period of 10 minutes to 1 hour, 15 minutes to one hour, 30 minutes to 1 hour, 45 minutes to 1 hour, 10 minutes to 45 minutes, 15 minutes to 45 minutes, 30 minutes to 45 minutes, 10 minutes to 30 minutes, 15 minutes to 30 minutes or 10 minutes to 15 minutes.
- the explant may be contacted with the gene delivery vehicle for the relevant period of time after extraction from the donor and prior to grafting into the recipient subject.
- the objective of the surgical method as a whole may be prophylaxis or treatment of coronary artery disease (CAD).
- the method may comprise a step of vascular grafting.
- the method may comprise a step of coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA).
- CABG coronary artery bypass grafting
- PTCA percutaneous transluminal coronary angioplasty
- the objective of gene transfer to the vascular cell or tissue may be, for example, vaccination or gene therapy.
- Gene therapy applications may include modulation of angiogenesis or vasculogenesis, e.g. promotion of angiogenesis or vasculogenesis (i.e. therapeutic angiogenesis/vasculogenesis, e.g. for treatment of ischaemia) or inhibition of angiogenesis or vasculogenesis (in situations where angiogenesis or vasculogenesis is undesirable, e.g. in the treatment of cancers or inflammatory conditions), prophylaxis or treatment of peripheral vascular disease, prophylaxis or treatment of restenosis (such as in-stent restenosis), prophylaxis or treatment of complications resulting from vascular surgery (e.g.
- prophylaxis or treatment of vein graft failure modulation of vascular cell proliferation (e.g. inhibition of undesirable vascular cell proliferation such as neointimal hyperplasia), modulation (e.g. inhibition or stimulation) of vascular cell apoptosis, modulation (e.g. inhibition or stimulation) of vascular cell migration, or prophylaxis or treatment of atheroma formation, atherosclerosis or vascular occlusion.
- the site of intended treatment may be a vascular graft.
- the gene delivery vehicle carries a nucleic acid payload for delivery to the target cell or tissue.
- the nucleic acid payload is normally a double stranded DNA (dsDNA) molecule.
- the nucleic acid payload typically comprises a heterologous gene (i.e. a gene not found in wild type adenoviruses) which is intended for introduction into and expression in the target vascular cell or tissue.
- the heterologous gene may be part of a transcription unit functional to express the heterologous gene in the target cell or tissue.
- the heterologous gene may be operably linked to a promoter and other appropriate transcriptional and translational regulatory signals.
- the heterologous gene may also be referred to as a "transgene". Introduction of the nucleic acid payload and its heterologous gene into a target cell or tissue is referred to as "transduction".
- the nucleic acid payload typically contains further elements required for it to be packaged into the adenoviral gene delivery vehicle and appropriately processed in the target vascular cell or tissue. These may include adenoviral inverted terminal repeat (ITR) sequences and an appropriate packaging signal.
- ITR adenoviral inverted terminal repeat
- the nucleic acid payload may also contain a selectable marker, i.e. a gene encoding a product which allows ready detection of transduced cells.
- a selectable marker i.e. a gene encoding a product which allows ready detection of transduced cells. Examples include genes for fluorescent proteins (e.g. GFP), enzymes which produce a visible reaction product (e.g. beta-galactosidase, luciferase) and antibiotic resistance genes.
- the adenoviral gene delivery vehicle is typically not replication-competent. That is to say, the nucleic acid does not contain all of the adenoviral genes (and other genetic elements) necessary for viral replication. Typically the nucleic acid lacks one or more functional adenoviral genes from the E1, E2, E3 or E4 regions. These genes may be deleted or otherwise inactivated, e.g. by insertion of a transcription unit comprising the heterologous gene or a selective marker. In some embodiments, the nucleic acid contains no functional adenoviral genes, in which case the only viral components present may be the ITRs and packaging signal. Gene transfer vehicles having no functional adenoviral genes may be preferred, as they reduce the risk of a host immune response developing against the transduced target cell or tissue as a result of viral protein synthesis.
- the heterologous gene is referred to herein as being "exogenous" to the target cell or tissue into which it is introduced. If the heterologous gene has no equivalent in the genome of the target cell or tissue, e.g. it encodes a product (RNA and/or protein) not already encoded by a gene in the target cell or tissue, then the exogenous gene may also be regarded as being heterologous to the target cell or tissue.
- the heterologous gene may encode any gene product which it is desirable to introduce to a vascular cell.
- genes are well known for use in methods of gene therapy, and include those encoding therapeutic proteins such as TPA, EPO, cytokines, antibodies or functional fragments or derivatives thereof, etc., as well as immunostimulatory factors like tumour-specific antigens, cytokines, etc..
- Anti-angiogenic factors such as endostatin, angiostatin, ATF-BPTI CDT-6, dominant negative VEGF-mutants, antibodies against VEGF, FGF, or functional fragments thereof, etc..
- Pro-angiogenic (or vasculogenic) factors including VEGF (e.g. isoform 121, 159, 206 or 165), Fibroblast growth factors (FGFs, including FGF2, 3, 4 and 5), hepatocyte growth factor (HGF), IGF, del-1 (developmentally-regulated endothelial locus 1), Nitric oxide synthases (e.g. inducible NOS, also known as iNOS), C-type natriuretic peptide, etc.. Many of these genes have been proposed in the literature as candidates for gene therapy approaches to angiogenesis and treatment of ischaemia. VEGF and nitric oxide synthases have been shown to be effective for inhibition of restenosis. VEGF may act via induction of nitric oxide synthase and/or prostacyclin, thus inhibiting VSMC proliferation and migration.
- FGFs Fibroblast growth factors
- HGF hepatocyte growth factor
- IGF hepatocyte growth factor
- del-1 developmentally-regulated
- Anti-inflammatory proteins such as soluble CD40, FasL, IL-12, IL-10, IL-4, IL-13 and antibodies or functional fragments or derivatives thereof (e.g. secreted single chain antibodies) against CD4, CD5, CD7, CD52, I1-2, IL-1, IL-6, TNF, etc. or the T-cell receptor on auto-reactive T-cells. Dominant negative mutants of PML may also be used to inhibit the immune response.
- antagonists of pro-inflammatory cytokines may be used, for example IL-1RA(receptor antagonist) and soluble receptors like siL-1RI, siL-1RII, sTNFRI and sTNFRII.
- IL-1RA receptor antagonist
- soluble receptors like siL-1RI, siL-1RII, sTNFRI and sTNFRII.
- Growth and/or immune response inhibiting genes such as ceNOS, Bcl3, cactus and IKB ⁇ , ⁇ or ⁇ .
- pro-apoptotic proteins like p53
- metalloprotease inhibitors e.g. TIMP 1-3
- suicide genes like HSV-TK, cytosine deaminase, nitroreductase and linamerase may be used.
- p53 has been suggested for use in inducing apoptosis in SMCs to prevent neointimal hyperplasia in human saphenous vein grafts.
- TIMPs such as TIMP 3 have been shown to inhibit neointimal hyperplasia by inducing SMC apoptosis, as well as by inhibiting migration of SMCs.
- TIMPs have also been shown to be effective for inhibition of restenosis.
- genes encoding polypeptides effective to prevent or inhibit neointimal hyperplasia, atheroma formation, vascular occlusion or atherosclerosis are also of interest. These include regulators of vascular remodelling such as Nogo-B.
- the heterologous gene may also encode a nucleic acid gene product, e.g. one capable of regulating expression of an endogenous gene in the target cell or tissue.
- regulatory nucleic acids include decoy oligodeoxynucleotides and nucleic acids capable of hybridising to mRNA or DNA of a target gene or inhibiting expression by co-suppression, such as ribozymes, antisense RNA or DNA molecules, siRNA, RNAi, etc..
- Regulatory nucleic acids (decoy oligodeoxynucleotides) directed against the transcription factor E2F have been shown to inhibit neointimal hyperplasia and vascular graft atherosclerosis in rabbits.
- Adenoviruses are non-enveloped viruses containing a linear double-stranded DNA genome which infect various mammalian species including humans.
- the genome is typically approximately 30-38 kp in length, and encodes a number of genes including so-called Early (E1a, E1b, E2a, E2b, E3, E4) and Late (L1, L2, L3, L4, L5) genes, flanked by 5' and 3' inverted terminal repeats (ITRs). It also contains a packaging signal.
- the genome is enclosed in a capsid composed of three major proteins, namely penton, hexon, and fiber.
- the hexon is the most abundant structural component of the capsid (accounting for 63% of the total protein mass of the virus) 17 and is composed of 240 trimeric capsomeres.
- the other two proteins are the 12 pentameric penton bases and the fiber protein (which is a trimeric rod-like structure that projects from the 12 penton bases).
- the fiber contains a C-terminal globular knob-like structure that mediates primary cell tethering interactions. These proteins together form the icosahedral shape of the non-enveloped capsid (with a diameter of 70-90 nm) that surrounds a double stranded 36kb DNA genome (reviewed in 20 ).
- the Ad fiber proteins are structured to interact with several different host cell receptors.
- the method for Ad infection in vitro is well defined, particularly for Ad5 (species C).
- Ads internalise into the host cells through endocytosis that is driven by the interaction of the cellular receptor of the host cell and the viral fiber protein and penton base.
- Initial interaction for most Ad species is between the fiber knob domain and the membrane glycoprotein coxsackievirus and adenovirus receptor (CAR). All Ad species except B can interact with CAR using the tight junction regulated fiber knob domain, although some species D Ads also use sialic acid.
- Species B Ads utilize CD46.
- Virus internalisation is stimulated through engagement of ⁇ v ⁇ 3 and ⁇ v ⁇ 5 integrins by the RGD motif in the penton base at the N-terminus of the fiber protein 21, 22 .
- Adenoviruses are frequently used as gene transfer vectors to deliver a nucleic acid payload to a target cell or tissue.
- the payload normally comprises or consists of a linear dsDNA molecule which in turn comprises a heterologous gene (often referred to as a transgene) which it is desired to introduce and express in the target cell or tissue.
- the nucleic acid payload carried by such vectors generally lacks one or more genes essential for viral replication, especially one or more Early genes.
- the viral gene is typically deleted from the viral genome and replaced by the heterologous gene or genes. These vectors are thus replication-defective and are not capable of productive infection resulting in generation of viral progeny which are identical to the parent (unless the same cell is also infected with a helper virus capable of complementing the deficiency present in the vector genome).
- the first generation lacked the E1 gene.
- the second generation combined deletion of E1 and/or E3 with deletions of E2 and/or E4.
- the third generation retains only the ITRs and packaging signal with the rest of the genome replaced by heterologous DNA, and are often called "gutless” or “gutted” vectors, or "helper-dependent adenoviruses” since they rely on a helper adenovirus to supply all viral proteins. See Alba et al. (Gene Ther. 8, 1347-1353, 2005 ) for a review. An overview of minimal vectors, packaging cells and ancillary techniques can also be found in WO99/55132 ( PCT/NL00/00235 ).
- the length of the nucleic acid payload is normally approximately 75-105% of the length of the wild type adenoviral genome appropriate to the capsid.
- the Ad49 genome is approximately 35.2 kb in length, so nucleic acid used in Ad49-based vectors will typically be approximately 26.5 to 37 kb in length.
- the heterologous gene (and its transcription unit) will normally be shorter than the optimum length for packaging, so the remainder of the nucleic acid payload will be composed of so-called "stuffer" sequence.
- This is typically non-coding sequence (e.g. intron sequences) but without elements such as repetitive sequences, recombination hotspots and extraneous regulatory elements that could interfere with maintenance and expression of the heterologous gene.
- a serotype is defined on the basis of its immunological distinctiveness as determined by quantitative neutralization with animal antisera (horse, rabbit).
- a serotype has either no cross-reaction with others, or shows a homologous-to-heterologous titer ratio of >16 in both directions. If neutralization shows a certain degree of cross-reaction between two viruses in either or both directions (homologous-to-heterologous titer ratio of 8 or 16), distinctiveness of serotype is assumed if (A) the hemagglutinins are unrelated, as shown by lack of cross-reaction on hemagglutination-inhibition, or (B) substantial biophysical/ biochemical differences in DNA exist ( Francki et al, 1991, Arch. Virol. Suppl. 2: 140-144 ).
- a whole genome sequence for adenovirus serotype 49 is provided in GenBank with the accession number DQ393829.1.
- Example sequences for the major Ad49 capsid proteins are provided in Figures 8 (hexon), 9 (fiber) and 10 (penton).
- Ad49 hexon protein is used herein to mean a hexon protein which shows the same pattern of serological reactivity with hexon proteins from other adenoviral serotypes as the hexon sequence provided in Figure 8 . Additionally or alternatively, an Ad49 hexon protein has the hexon sequence provided in Figure 8 or a sequence having at least 93%, 94%, 95% 96%, 97%, 98%, or 99% identity to that sequence, or is a functional fragment of either.
- Ad49 fiber protein is used herein to mean a fiber protein which shows the same pattern of serological reactivity with fiber proteins from other adenoviral serotypes as the fiber sequence provided in Figure 9 . Additionally or alternatively, an Ad49 fiber protein has the fiber sequence provided in Figure 9 or a sequence having at least 80%, 81%, 82%, 83%, 84%, 85%, 86%, 87%, 88%, 89%, 90%, 91%, 92%, 93%, 94%, 95% 96%, 97%, 98%, or 99% identity to that sequence, or is a functional fragment of either.
- Ad49 penton protein is used herein to mean a penton protein which shows the same pattern of serological reactivity with penton proteins from other adenoviral serotypes as the penton sequence provided in Figure 10 . Additionally or alternatively, an Ad49 penton protein has the penton sequence provided in Figure 10 or a sequence having at least 98%, or 99% identity to that sequence, or is a functional fragment of either.
- a conservative substitution may be defined as a substitution within an amino acid class and/or a substitution that scores positive in the BLOSUM62 matrix.
- the amino acid classes are acidic, basic, uncharged polar and nonpolar, wherein acidic amino acids are Asp and Glu; basic amino acids are Arg, Lys and His; uncharged polar amino acids are Asn, Gln, Ser, Thr and Tyr; and non-polar amino acids are Ala, Gly, Val, Leu, Ile, Pro, Phe, Met, Trp and Cys.
- the amino acid classes are small hydrophilic, acid/acid amide/hydrophilic, basic, small hydrophobic and aromatic, wherein small hydrophilic amino acids are Ser, Thr, Pro, Ala and Gly; acid/acidamide/hydrophilic amino acids are Asn, Asp, Glu and Gln; basic amino acids are His, Arg and Lys; small hydrophobic amino acids are Met, Ile, Leu and Val; and aromatic amino acids are Phe, Tyr and Trp
- Percent (%) amino acid sequence identity with respect to a reference sequence is defined as the percentage of amino acid residues in a candidate sequence that are identical with the amino acid residues in the reference sequence, after aligning the sequences and introducing gaps, if necessary, to achieve the maximum percent sequence identity, and not considering any conservative substitutions as part of the sequence identity.
- % identity values may be determined using the publically available alignment program MUSCLE ( Edgar, 2004, Nucleic Acids Res. 32(5):1792-1797 ) using default parameters.
- a % amino acid sequence identity value is determined by the number of matching identical residues as determined by MUSCLE, divided by the total number of residues of the reference sequence (gaps introduced by the program into the reference sequence to maximize the alignment score being ignored), multiplied by 100.
- the hexon protein in combination with fiber proteins having the sequence of Figure 9 and penton proteins having the sequence of Figure 10 , is capable of forming functional adenoviral virions capable of mediating vascular SMC or EC transduction at 50% or more (and preferably 60%, 70%, 75%. 80%, 85%, 90% or 95% or more) of the level provided by that of an otherwise identical gene transfer vehicle having a capsid composed of hexon, fiber and penton proteins having the sequences shown in Figures 8 to 10 respectively.
- the fiber protein in combination with hexon proteins having the sequence of Figure 8 and penton proteins having the sequence of Figure 10 , is capable of forming functional adenoviral virions capable of mediating vascular SMC or EC transduction at 50% or more (and preferably 60%, 70%, 75%. 80%, 85%, 90% or 95% or more) of the level provided by that of an otherwise identical gene transfer vehicle having a capsid composed of hexon, fiber and penton proteins having the sequences shown in Figures 8 to 10 respectively.
- the penton protein in combination with hexon proteins having the sequence of Figure 8 and fiber proteins having the sequence of Figure 9 , is capable of forming functional adenoviral virions capable of mediating vascular SMC or EC transduction at 50% or more (and preferably 60%, 70%, 75%. 80%, 85%, 90% or 95% or more) of the level provided by that of an otherwise identical gene transfer vehicle having a capsid composed of hexon, fiber and penton proteins having the sequences shown in Figures 8 to 10 respectively.
- the level of transduction can be determined using primary human vascular SMCs in serum free medium, 37°C, at 2x10 4 cells per well in a 96 well plate format. Cells are incubated with 10 4 virus particles per cell for 30 minutes, before being washed with PBS. The cells are then maintained under the original conditions (serum free medium, 37°C) for 48 hours before determining the level of transduction.
- the level of transduction can be determined by measuring the level of expression of the transgene, normalised appropriately to cell number or total protein in the well. Expression may be assessed directly (as absolute protein concentration) or indirectly, e.g. via enzymatic activity.
- a suitable transgene for use in the assay is luciferase, which may be expressed under the control of the CMV (cytomegalovirus) promoter. Luciferase assays measure intensity of light produced by action of the enzyme on a luciferin substrate in the presence of ATP-Mg 2+ . The skilled person is well aware of suitable protocols for such determination, and the precise protocol used is not important. Examples include the Luciferase Assay System commercially available from Promega ® .
- the gene transfer vehicle may comprise other adenoviral proteins as appropriate, including minor capsid proteins, enzymes, etc..
- Ad49 proteins have the following GenBank accession numbers (although the skilled person will be well capable of creating viral vectors having different proteins if desired):
- the gene delivery vehicle comprises an E4-orf6 gene from adenovirus serotype 5.
- This allows propagation of E1-deleted Ad49 viruses in commonly-used Ad5-E1-complementing cell lines, such as HEK293 or PER.C6 cells. See, for example, WO03/104467 , and Lemckert et al., (2006) 28 ., which also provide further details regarding the production of vectors based on Ad49.
- an E1-deleted Ad49 virus does not comprise E4-orf6 of Ad5, in which case the vector can be complemented in_a cell line that expresses both E1 and a compatible E4orf6, e.g.
- Cardiovascular diseases including coronary artery diseases (CAD) are the leading cause of death in the developed world. Globally, about 17.1 million people die each year due to CVD reflecting 29% of all deaths. It is also estimated that the rate will increase reaching 23.6 million by 2030. 1
- IHD ischemic heart disease
- CABG coronary artery bypass grafting
- PTCA percutaneous transluminal coronary angioplasty
- Arterial sources as grafting vessels have also been used in CABG, such as the left internal mammary artery (LIMA), radial artery, the right gastroepiploic artery, and the inferior epigastric artery, 4, 8 but the use of arterial sources for grafting has its own limitations, such as the increase in the duration and technical difficulty of the operation, the short length of the blood vessels available for grafting, as well as the possible occurrence of arterial spasm, especially when using the radial artery as a graft 4 . These procedures tend to be used more in younger patients who have a longer life expectancy 9 .
- LIMA left internal mammary artery
- radial artery the right gastroepiploic artery
- inferior epigastric artery 4, 8
- the use of arterial sources for grafting has its own limitations, such as the increase in the duration and technical difficulty of the operation, the short length of the blood vessels available for grafting, as well as the possible occurrence of arterial spasm, especially when using the radial
- CAD CAD
- Other surgical intervention methods used to treat CAD include PTCA (also known as balloon angioplasty) and stenting (the use of an expandable metal tube in order to keep the blocked artery open after angioplasty).
- PTCA also known as balloon angioplasty
- stenting the use of an expandable metal tube in order to keep the blocked artery open after angioplasty.
- these methods also suffer from marked re-narrowing of the blood vessels after the procedure due to restenosis 10 .
- vascular smooth muscle cells form the medial layer of the blood vessels and have the ability to remodel their phenotype in response to changes in their local environment, such as blood flow, stress on the inner lumen of the saphenous vein used in CABG, and injuries such as those caused by balloon PTCA. These changes cause the VSMC to shift from a differentiated state to a de-differentiated state and this modulation ends with the formation of neointimal lesions 6, 11, 12 .
- Neointimal hyperplasia is caused by the migration and proliferation of VSMC from the medial to the intimal layer of the vasculature and causes the vein graft to be susceptible to accelerated atherosclerosis 13 . This process is induced by cytokines and growth factors that are released from injured endothelial and smooth muscle cells, aggregating platelets, and macrophages 14, 15 . In that sense, the inhibition of neointimal formation at an early stage is important for the prevention of vein graft occlusion and atheroma formation.
- vein grafts In order to prevent neointimal lesion formation and prolong the life span of vein grafts, therapeutic gene transfer into the wall of vein grafts might have the potential to prevent late graft failure.
- Vein grafts are considered to be perfect targets for gene therapy owing to the fact that explanted veins can be transduced ex vivo before the actual grafting process, thus avoiding the numerous limitations and difficulties associated with in vivo gene transfer.
- MMPs Metalloproteinases
- TMP-3 tissue inhibitor of metalloproteinase-3
- Inducing VSMC apoptosis by overexpressing the tumour suppressor gene p53 has also been investigated in order to regulate VSMC migration and proliferation, thus leading to a reduced intimal thickening and of intimal cell number 24 .
- Another method of reducing neointimal formation is over expressing the protein Nogo-B which is believed to be a regulator of vascular remodelling. Nogo-B is lost following vascular injury, and by over-expressing it a reduction in proliferation and migration of the VSMC was seen in porcine and murine neointimal models 25 .
- HSVEC Human Saphenous Vein Endothelial cells
- HSVSMC Smooth Muscle Cells
- TCS Cell Works, UK endothelial cell complete media
- FCS foetal calf serum
- DMEM Dulbecco's modified Eagle's medium
- Human embryonic kidney HEK293 cells and HepG2 cells were cultured in minimal essential medium supplemented with 100 IU/mL penicillin, 100 mg/mL streptomycin, 2 mmol/L L-glutamine (Invitrogen), 10% (vol/vol) FCS (FCS; PAA Laboratories) and 1 mM sodium pyruvate (Sigma-Aldrich).
- Cells were cultured as a monolayer and media was replaced every 3-4 days. Cells were routinely maintained at approximately 80% confluence to prevent overgrowth and loss of surface contact. In the passage process, cells were washed in 10 ml PBS and were incubated in 3 ml of TE (trypsin-EDTA, Gibco, Paisley, UK) for approximately 3 minutes at 37°C until the detachment of the cells from the flask. After that, 5 ml of complete media was added in order to counteract the effect of TE. Cells were collected by configuration at 1500 rpm for 5 minutes and then were resuspended in complete media for passaging or seeding. Before seeding cells were counted using a haemocytometer to make sure of the required seeding density.
- TE trypsin-EDTA
- Transduction experiments were performed in a 96 well-format with 2x10 4 hSMCs per well.
- Cells were infected with adenoviruses at a doses ranging from 1000 to 10000 VP/cell depending on the experiment (see legend) in serum-free medium.
- Cells were infected for time periods ranging from 10 minutes - 3 hours depending on the experiment (see separate figure legends) at 37 °C, washed with PBS, and maintained until harvesting 48 hours post-infection.
- cells were blocked (on ice for 1 hour) using either 5 ⁇ g/10 5 cells of recombinant Ad5 knob protein (to block CAR receptors) or 2.5 ⁇ g/ml of CD46 blocking MEM258 antibody.
- the blocking agent was left on the cells for an additional hour in the presence of adenovirus (100 vp/cell) on ice for 1 hour, before the virus/blocking agent was removed from the cells, the cells washed in cold PBS and cultured for a further 48 hours in complete media prior to assay for luciferase expression. Luciferase activity was quantified using luciferase assay reagent (Promega) according to manufacturer's instructions. In some experiments where adenovirus expressing eGFP was used, cells were imaged using a fluorescence microscope, and the percentage cells positive for eGFP was quantified using a BD FACS Canto.
- Luciferase activity was quantified using a Wallac VICTOR2 luminometer (Perkin Elmer Life and Analytical Sciences, Boston, MA, USA). Protein concentrations were calculated using a BCA assay (Thermo Scientific, Winsford, United Kingdom). Values are expressed as relative light units (RLU) per milligram of protein.
- A549 cells were infected with 10000 vp/cell of luciferase expressing forms of each vector in the presence or absence of 2.5% sera from patients undergoing CABG within a Glasgow cohort. Luciferase expression was gauged as described earlier, and normalised to protein. The % change in transduction compared to no serum control was calculated, and serums which reduced transduction by greater than 90% were considered as highly neutralising.
- Ad49 knob sequence (generated by geneART with Ad5 hinge region and 6x HIS tag) or Ad5 knob sequence was cloned into pQE inducible expression vector. Protein production induced with IPTG and purified by affinity chromatography and eluted with increasing concentrations of imidizole. The capacity of the knob protein to trimerise was confirmed by running the purified protein under naturing or denaturing conditions. The trimeric protein was then used in transduction assays to compete out Ad5 or Ad49 mediated transduction as described earlier.
- hSMCs human smooth muscle cells
- hECs human endothelial cells
- Ad35 The CD46-utilising Ad35 is able to mediate significantly higher levels of transduction in hSMCs when compared with Ad5.
- Ad49 for which the receptor usage is unknown, shows significantly higher levels of transduction than Ad5 or Ad35 at all doses tested.
- Ad49 was also found to be capable of transducing vascular endothelial cells (data not shown).
- Ad49 mediates highly efficient transduction in hSMCs even following limited contact time with the target cells.
- Pre-existing anti vector immunity acquired through previous exposure to the wild type pathogens may limit clinical efficacy of these virus based gene therapy agents.
- transduction assays by incubating luciferase expressing Ad5, Ad35 and Ad49 and incubating them with 2.5% serum from patients undergoing CABG procedure (Scottish cohort) prior to infecting HepG2 cells (20,000 cells/well, 10,000 vp/cell).
- the effect of serum on Ad mediated luciferase expression was quantified 48 hours post infection.
- Sera were categorised into 3 groups: neutralising (i.e. reduced luciferase expression by greater than 90% vs no serum control), no effect luciferase expression (i.e. 10-100% no serum control) or enhancing (i.e. luciferase expression was greater than 100% that of the no serum control) ( Figure 3 ).
- Ad49 knob sequence (generated by geneART with Ad5 hinge region and 6x HIS tag) into pQE inducible expression vector. Protein production was induced with IPTG and the protein purified by affinity chromatography and eluted with increasing concentrations of imidizole. We confirmed that the recombinant protein trimerises (data not shown).
- Ad5 knob protein efficient and dose dependently inhibited transduction mediated by Ad5, but had no effect on Ad49 transduction. Intriguingly, Ad49 knob protein had no effect on Ad49 transduction, however it was able to inhibit CAR mediated Ad5 infectivity, albeit at 1-2 logs higher dose than Ad5 knob protein ( Figure 4 ).
- Ad49 knob protein binds CAR and blocks CAR mediated Ad5 infectivity (albeit 1-2 logs lower affinity than Ad5 knob), but fails to block infectivity of Ad49, suggesting that Ad49 transduction is independent of knob interactions.
- Ad49 was found to mediate significantly higher levels of gene expression than Ad5.
- Ad49 is significantly more efficient at transducing vasculature ex vivo than Ad5, and that Ad49 uptake and transduction occurs within a rapid, clinically relevant window.
- Ad49 can efficiently transduce pig vasculature in ex vivo procedures, and is more efficient than Ad5 especially at lower doses. Since our data suggests that the pig isoform of CD46 is sufficiently different to the human form to prevent transduction with species B adenoviruses (e.g. Ad35) this also provides additional evidence that the receptor(s) utilized by Ad49 is not CD46.
- species B adenoviruses e.g. Ad35
- Ad49 vascular cells from excess tissue from bypass graft operations
- 10 9 vp of Ad5 or Ad49 as described in the preceeding sections.
- Ad49 mediated higher levels of transgene expression in the vessel ( ⁇ 25 x higher) compared to Ad5 at the same dose.
- Ad49 is highly efficient at transducing human vascular tissue ex vivo.
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Claims (13)
- Vecteur de délivrance de gène adénoviral destiné à être utilisé dans un procédé de délivrance de gène thérapeutique ou prophylactique à une cellule ou à un tissu vasculaire, dans lequel le vecteur de délivrance de gène adénoviral comprend une protéine hexon d'Ad49, une protéine penton d'Ad49 et une protéine fibre d'Ad49.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon la revendication 1, dans lequel ledit procédé comprend l'administration dudit vecteur de délivrance de gène adénoviral à un sujet.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon la revendication 1, dans lequel ledit procédé comprend les étapes consistant à fournir une cellule ou un tissu vasculaire, à mettre en contact la cellule ou le tissu avec un vecteur de délivrance de gène adénoviral pour fournir une cellule ou un tissu génétiquement modifié(e), et introduire la cellule ou le tissu génétiquement modifié(e) chez un sujet.
- Procédé de délivrance de gène in vitro ou ex vivo à une cellule ou à un tissu vasculaire, comprenant la mise en contact de ladite cellule ou dudit tissu vasculaire in vitro ou ex vivo avec un vecteur de délivrance de gène adénoviral, dans lequel le vecteur de délivrance de gène adénoviral comprend une protéine hexon d'Ad49, une protéine penton d'Ad49 et une protéine fibre d'Ad49.
- Procédé selon la revendication 4, dans lequel la cellule ou le tissu vasculaire est destiné(e) à être introduit(e) chez un sujet.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon l'une quelconque des revendications 1 à 3 ou procédé selon la revendication 4 ou 5, dans lequel la cellule ou le tissu vasculaire comprend une longueur de vaisseau sanguin.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon la revendication 6 ou procédé selon la revendication 6, dans lequel la longueur du vaisseau sanguin est dérivée de la veine saphène, d'une artère mammaire interne (par exemple de l'artère mammaire interne gauche), d'une artère gastroépiploïque (par exemple l'artère gastroépiploïque droite), ou d'une artère épigastrique inférieure.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon l'une quelconque des revendications 1 à 3, 6 ou 7, ou procédé selon l'une quelconque des revendications 4 à 7, dans lequel le transfert de gène est effectué pour la modulation de l'angiogenèse ou de la vasculogenèse, la prophylaxie ou le traitement d'une maladie vasculaire périphérique, la prophylaxie ou le traitement d'une resténose, la prophylaxie ou le traitement de complications résultant d'une chirurgie vasculaire, la prophylaxie ou le traitement d'une défaillance d'une greffe veineuse, la modulation de la prolifération de cellules vasculaires, la modulation de l'apoptose de cellules vasculaires, la modulation de la migration de cellules vasculaires ou la prophylaxie ou le traitement d'une formation d'athérome, d'une athérosclérose ou d'une occlusion vasculaire.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon l'une quelconque des revendications 1 à 3 ou 6 à 8, ou procédé selon l'une quelconque des revendications 4 à 8, dans lequel le vecteur de délivrance de gène adénoviral n'est pas compétent pour la réplication.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon la revendication 9, ou procédé selon la revendication 9, dans lequel l'acide nucléique contenu dans le vecteur de délivrance de gène manque d'un ou plusieurs gènes adénoviraux fonctionnels en provenance des régions E1, E2, E3 ou E4.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon la revendication 9 ou 10, ou procédé selon la revendication 9 ou la revendication 10, dans lequel l'acide nucléique ne contient pas de gènes adénoviraux fonctionnels.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon l'une quelconque des revendications 1 à 3 ou 6 à 11, ou procédé selon l'une quelconque des revendications 4 à 11, dans lequel la charge utile d'acide nucléique portée par le vecteur de délivrance de gène comprend un gène hétérologue codant pour une cytokine, un anticorps, un facteur immuno-stimulateur, un facteur anti-angiogénique, un facteur angiogénique, une protéine anti-inflammatoire, un régulateur de remodelage vasculaire, un facteur pro-apoptotique pour des cellules vasculaires, ou un inhibiteur de métalloprotéase.
- Vecteur de délivrance de gène adénoviral pour une utilisation selon l'une quelconque des revendications 1 à 3 ou 6 à 12, ou procédé selon l'une quelconque des revendications 4 à 12, dans lequel la charge utile d'acide nucléique portée par le vecteur de délivrance de gène comprend un gène hétérologue codant pour un acide nucléique capable de s'hybrider à l'ARNm ou à l'ADN d'un gène cible ou capable d'inhiber l'expression d'un gène cible par co-suppression.
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| JP7015551B2 (ja) | 2016-02-23 | 2022-02-15 | ソーク インスティテュート フォー バイオロジカル スタディーズ | ウイルス動態への影響を最小限にするための治療用アデノウイルスにおける外因性遺伝子発現 |
| WO2017147265A1 (fr) | 2016-02-23 | 2017-08-31 | Salk Institute For Biological Studies | Dosage à haut débit pour mesurer la cinétique de réplication d'un adénovirus |
| CA3045892A1 (fr) | 2016-12-12 | 2018-06-21 | Salk Institute For Biological Studies | Adenovirus synthetiques ciblant une tumeur et leurs utilisations |
| BR112020019942A2 (pt) | 2018-04-09 | 2021-01-26 | Salk Institute For Biological Studies | composições de adenovírus oncolítico com propriedades de replicação aprimoradas |
| WO2020172509A1 (fr) * | 2019-02-21 | 2020-08-27 | Unleash Immuno Oncolytics, Inc. | Vecteur adénoviral oncolytique et procédés d'utilisation |
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